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Pulmonary hypertension (PH) is raised blood pressure within the pulmonary arteries, which are the blood vessels that supply the lungs.
It is a serious medical condition that can damage the right side of the heart, making the heart less efficient at pumping blood around the body and getting oxygen to the muscles. In a healthy person, blood travels through the pulmonary arteries from the right-hand side of the heart, picking up oxygen when it reaches the lungs. Oxygen-rich blood from the lungs returns to the left-hand side of the heart, where it is pumped around the body to the muscles, where the oxygen is needed. If you have pulmonary hypertension, the walls of your pulmonary arteries are thick and stiff, making it difficult for them to expand to allow more blood through. Alternatively, your pulmonary arteries may be blocked by blood clots which can also hinder blood flow. The reduced blood flow makes it difficult for the right-hand side of your heart to pump blood through the arteries, which means that this part of the heart has to work harder. If the right-hand side of your heart has to continually work harder, it may gradually become weaker. This will make it less efficient at pumping blood and can lead to heart failure.
Fig 1: Illustration of mechanism of blood flow to heart in PH Fig 2: Illustration of enlarged right ventricle (external view) Fig 3: Illustration of normal heart and heart with PH Photo credit: http://www.phatoronto.ca
Diseases or conditions, such as heart and lung diseases or blood clots, usually cause PH. Some people inherit the condition. In some cases, the cause isn't known. PH usually develops between the ages of 20 and 60, but it can occur at any age. People who are at increased risk for PH include:
Those who have a family history of the condition.
Those who have certain diseases or conditions, such as heart and lung diseases, liver disease, HIV infection, or blood clots in the pulmonary arteries.
Those who use street drugs (such as cocaine) or certain diet medicines.
Pulmonary hypertension is a potentially serious health condition that can lead to heart failure.
Self-care instructions: Follow
your treatment plan as your doctor advises. Call your doctor if your PH
symptoms worsen or change. The earlier symptoms are addressed, the
easier it is to treat them.
Some symptoms, such as chest pain, may require emergency treatment. Ask your doctor when you should call him or her or seek emergency care.
talk with your doctor before taking any over-the-counter medicines.
Some medicines can make your PH worse or interfere with the medicines
you're taking for PH. Ask your doctor whether you should get a pneumonia vaccine and a yearly flu shot.
You may have a complex schedule for taking medicines. Don't stop or change medicines unless you talk with your doctor first.
Pay careful attention to your weight.
You may want to keep a daily record of your weight. You should weigh
yourself at the same time each day. If you notice a rapid weight gain
call your doctor. This may be a sign that your PH is worsening. Pregnancy is risky
for women who have PH. Consider using birth control if there is a
chance you may become pregnant. Ask your doctor which birth control
methods are safe for you. Signs and symptoms of pulmonary hypertension (PH) may include:
Shortness of breath during routine activity, such as climbing two flights of stairs
A racing heartbeat
Pain on the upper right side of the abdomen
As PH worsens, you may find it hard to do any physical activities. At this point, other signs and symptoms may include:
Feeling light-headed, especially during physical activity
Fainting at times
Swelling in your legs and ankles
A bluish color on your lips and skin
As pulmonary hypertension progresses, carrying out everyday activities may also become difficult. If your condition starts impact on your everyday life, it can affect your quality of life and may lead to depression. Visit your doctor if you feel depressed so they can recommend appropriate treatment.
If you have a type of pulmonary hypertension known as pulmonary arterial hypertension (PAH), you may not experience any symptoms until the condition is quite advanced.
Untreated pulmonary hypertension can lead to heart failure, where your heart struggles to pump enough blood around your body. As well as shortness of breath and tiredness, heart failure can also cause:
swelling in the legs, ankles and feet (oedema)
waking up in the middle of the night gasping for breath
A healthy lifestyle will make your heart healthier. Here are 10 things you can do to improve yours.
Do 150 minutes of moderate-intensity aerobic activity every week. One way to achieve this target is by doing 30 minutes of activity on five days a week. Fit it in where you can, such as by cycling to work.
Give up smoking
Smoking is one of the main causes of coronary heart disease and pulmonary hypertension. A year after giving up, your risk of a heart attack falls to about half that of a smoker
Manage your weight
Being overweight can increase your risk of heart disease. Stick to a well-balanced diet low in fat and high in fruit and vegetables, combined with plenty of physical activity.
Ditch the salt
To maintain a healthy blood pressure, stop using salt at the table and try adding less to your cooking, or cut it out completely. You'll soon get used to it. Also watch out for high salt levels in processed foods. Check the food labels a food is high in salt if it has more than 1.5g salt (or 0.6g sodium) per 100g
Get your 5 A DAY
Eat five portions of fruit and vegetables a day. Add dried fruit to breakfast cereal, and add vegetables to your pasta sauces and curries.
Eat oily fish
Eat fish twice a week. Fish such as mackerel, sardines, fresh tuna and salmon are an excellent source of omega-3 fats, which can help protect against heart disease.Limit intake of tea, coffee, colas and chocolate to only 1 Cup a day. Lowered caffeine intake is known to induce a better sleep during the night and reduce BP
Walk off stress
If you're feeling under pressure, clear your mind with a walk. It will help put your ideas in order and reduce tension. If it's a brisk walk, it will also count towards your daily activity.
Cut saturated fat
Small changes to your diet can have positive health benefits. Choose semi-skimmed over full-fat milk, leaner cuts of meat, and steam or grill foods rather than frying
Alcohol can be fattening. If you added three or four gin and tonics to your usual daily diet, you could put on nearly 2kg over four weeks.
Emotional Issues and Support
Living with PH may cause fear, anxiety, depression, and stress. You may worry about your medical condition, treatment, finances, and other issues.
Joining a patient support group may help you adjust to living with PH. You can see how other people who have the same symptoms have coped with them. Talk with your doctor about local support groups or check with an area medical centre.
Following a healthy diet and maintaining a healthy weight are part of a healthy lifestyle. A healthy diet includes a variety of fruits, vegetables, and whole grains. It also includes lean meats, poultry, fish, and fat-free or low-fat milk or milk products. A healthy diet also is low in saturated fat, trans-fat, cholesterol, sodium (salt), and added sugar.
Talk with your doctor about whether you need to limit the amount of salt and fluids in your diet. Ask him or her whether you also need to regulate foods that contain vitamin K. These foods can affect how well blood-thinning medicines work. Vitamin K is found in green leafy vegetables and some oils, such as canola and soybean oil.
Take your medications properly and on time.
DASH Eating Plan
Dietary Approaches to Stop Hypertension (DASH) is a flexible and balanced eating plan.
- Is low in saturated fat, cholesterol, and total fat - Focuses on fruits, vegetables, and fat-free or low-fat dairy products - Is rich in whole grains, fish, poultry, beans, seeds, and nuts - Contains fewer sweets, added sugars and sugary beverages, and red meats - The DASH eating plan also is lower in sodium (salt). The DASH research showed that an eating plan containing 2,300 milligrams (mg) of sodium per day lowered blood pressure. An eating plan containing only 1,500 mg of sodium per day even further lowered blood pressure.
Sample Diet Plan
- 1 200 ml glass water 1 tsp honey 1 tsp lemon juice
- 4 almonds or 4 black dates
- 2 rawa idlis or 1 multigrain dosa 1 cup skimmed milk 1 apple or banana
- 2 whole wheat or multigrain( ragi jowar bajra) rotis 1 bowl rajma or other beans 1 bowl salad
- 1 small bowl
- 1 big bowl vegetable soup or 1 200ml glass milk-shake ( low fat milk) or 1 small cup tea with 2 multigrain biscuits
- 1 roti 1 bowl salad 1 bowl rice with dal or khichdi small bowl of dessert with low sugar
- 1/2 cup low fat milk with saffron or dried ginger powder (saunth)